Insomnia affects millions of adults worldwide, with nearly 16% of the global population struggling to fall or stay asleep. Many turn to sleep pills or supplements like melatonin, believing them to be safe, natural ways to improve sleep quality.
However, a new study presented at the American Heart Association’s Scientific Sessions 2025 raises alarm about the potential heart risks of long-term sleep aid use. Researchers found that adults taking sleep drugs for 12 months or longer had a 90% higher risk of developing heart failure over five years compared to those not using these medications.
The study analyzed medical records of over 131,000 adults with insomnia. Participants who had used melatonin or similar sleep drugs for more than a year were 3.5 times more likely to be hospitalized for heart failure and twice as likely to die from any cause during the follow-up period.
Experts warn of unexpected risks
Dr. Ekenedilichukwu Nnadi, the study’s lead author, emphasized that while these findings show a strong association, they do not prove a direct cause-and-effect relationship. “Further research is needed to determine whether sleep drugs directly contribute to heart failure or if other underlying conditions linked to insomnia are involved,” he explained.
Cardiologists not involved in the study also expressed concern. Dr. Kanika P. Mody, an advanced heart failure specialist, noted that melatonin and similar sleep aids are widely considered safe, yet the study’s results are unexpected and noteworthy. She added that insomnia itself can sometimes mask early signs of heart failure, highlighting the need for proper evaluation before relying on long-term sleep medication.
How to improve sleep safely
Experts advise exploring non-drug methods to manage insomnia and improve sleep quality:
- Maintain consistent sleep schedules and practice good sleep hygiene.
- Limit screen exposure and caffeine intake before bedtime.
- Incorporate daily physical activity and avoid heavy meals late at night.
- Consult a healthcare professional to rule out underlying issues such as sleep apnea.
- If sleep drugs are necessary, use the lowest effective dose—for melatonin, typically 1–3 mg—and take it 1–2 hours before bedtime.
Dr. Yu-Ming Ni, a cardiologist at MemorialCare Heart and Vascular Institute, warned that over-the-counter sleep pills are not FDA regulated, and dosages may vary widely between products. This variability may contribute to potential heart risks.
Bottom line
While sleep pills and melatonin supplements can provide short-term relief for insomnia, this research suggests that long-term use may carry significant heart risks. Patients are encouraged to discuss alternatives with their doctors, monitor their heart health, and consider lifestyle and behavioral strategies before relying on sleep medications for extended periods.
